The online survey by HealthPocket, a website that compares and ranks health plans, indicated most people don’t understand the most fundamental change to health plan designs under health reform.

When respondents were asked how the new PPACA bronze, silver, gold and platinum health plans differ from one another, 86 percent said they didn’t know.

Only 4 percent correctly answered that the percentage of medical costs covered by insurance is the differing factor. The remainder chose incorrect answers provided from HealthPocket.

The PPACA creates four basic health plan designs—bronze, silver, gold and platinum—to replace existing health plans and address the needs of most plan shoppers who aren't enrolled in a grandfathered health plan, Medicaid or Medicare.

All plans will share a mandatory set of insurance coverage features known as the essential health benefits. But the plans differ from one another based on the percentage of medical expenses paid by the insurance plan, ranging from 60 percent of expenses (the bronze plan) to 90 percent of expenses (the platinum plan).

The new poll, released this week, is the latest research to suggest a lack of consumer awareness regarding reform. The latest health tracking poll from the Kaiser Family Foundation found that 57 percent of Americans say they still don’t have enough information to understand how PPACA will affect them.

Uncertainty is even worse for some of the key groups the law was designed to help most: the uninsured (67 percent) and those with incomes below $40,000 (68 percent).

HealthPocket CEO Bruce Telkamp said education and community outreach efforts are “going to be critical if Americans are to make informed choices about their health care.”